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Patient Access Representative

5 months ago

Plymouth, United States Cape Cod Hospital Full time
  • Interview patient and/or patient representative to obtain required information necessary to complete the registration process in the hospital information system and maintains the accuracy, confidentiality and integrity of the automated database.
  • Coordinate and communicate accurate and updated registration/admission/and pre-admission activities with Medical Records, Care/Case Management, Utilization Management, Physicians' offices, Patient accounts, and any other hospital departments, as may be required, to support the appropriate, accurate, safe and effective patient care.
  • Initiate and maintain organized files and records, related to orders, payer authorizations, booking slips, schedules, and others per department procedure.
  • Contacts patients, employers, insurers and patient representatives to obtain insurance and other information necessary to secure hospital reimbursement, verifies benefits and pre-certifies all insurance plans to ensure maximum reimbursement to the hospital.
  • Verifies benefits, utilizing insurance verification systems. Obtains referrals and authorizations required and documents complete information, along with approved bed status, if applicable, in the computer system. Obtains pre-certifications in a manner to ensure maximum allowable reimbursement to the hospital.
  • Maintains a thorough knowledge of departmental policies and procedures to ensure maximum reimbursement to the hospital.
  • Attends departmental and other meetings as requested by the immediate supervisor.
  • Ensure timely placement of patients in the most effective and appropriate manner. Process admissions, discharges and transfers of all Hospital patients, per department procedures.
  • Explain and process payments from patients, which may include but not limited to co-pays, co-insurance, and deductibles
  • Follows department procedures related to securing payment information and providing patient receipts.
  • Provide information to patient and/or representative on: Health Care Proxy, Advanced Beneficiary Notice, Important Medicare Message (IMM) forms, Financial issues and refers to Financial Counselor if appropriate. Obtain completed forms as available.
  • Consistently provides service excellence to all patients, family members, visitors, volunteers and co-workers.
  • Perform other work related duties and activities as assigned or requested by manager/supervisor.
  • Ability to read, write and communicate in English at the level of a high school graduate.
  • Ability to type at the rate of 25 WPM as demonstrated by a timed test.
  • Computer skills to perform the job functions in a satisfactory, accurate and productive manner.
  • Successful passage of a Medical Terminology course or successful passage of Medical Terminology challenge exam.
  • Ability to work independently and under pressure.